1. Technical Field
The present disclosure relates to surgical apparatus for fastening objects to body tissue and, more particularly, to a coil fastener applier having a flexible shaft configured to apply helical coil fasteners to surgical mesh and tissue during surgical repair of the body tissue in procedures such as hernia repair.
2. Background of Related Art
Various surgical procedures require instruments capable of applying fasteners to tissue to form tissue connections or to secure objects to tissue. For example, during hernia repair it is often desirable to fasten a mesh to body tissue. In certain hernias, such as direct or indirect inguinal hernias, a part of the intestine protrudes through a defect in the support abdominal wall to form a hernial sac. The defect may be repaired using an open surgery procedure in which a relatively large incision is made and the hernia is closed off outside the abdominal wall by suturing. The mesh is attached with sutures over the opening to provide reinforcement.
Less invasive surgical procedures are currently available to repair a hernia. In laparoscopic procedures surgery is performed in the abdomen through a small incision while in endoscopic procedures, surgery is performed through narrow endoscopic tubes or cannulas inserted through small incisions in the body. Laparoscopic and endoscopic procedures generally require long and narrow instruments capable of reaching deep within the body and configured to seal with the incision or tube they are inserted through. Additionally, the instruments must be capable of being actuated remotely, that is, from outside the body.
Currently endoscopic techniques for hernia repair utilize fasteners, such as, surgical staples or clips, to secure the mesh to the tissue to provide reinforcement to the repair and structure for encouraging tissue ingrowth. The staples or clips need to be compressed against the tissue and mesh to secure the two together.
One other type of fastener suited for use in affixing mesh to tissue, during procedures such as hernia repair, is a coil fastener having a helically coiled body portion terminating in a tissue penetrating tip. An example of this type of fastener is disclosed in U.S. Pat. No. 5,258,000.
Existing coil fastener appliers are often designed for linear and non-intralumenal use, i.e., they are generally used for affixing mesh to an essentially flat tissue surface via a coil fastener. In certain situations, it may be desirable to fire surgical fasteners intralumenally. While some surgical instruments (e.g., surgical staplers) exist for firing surgical fasteners (e.g., surgical staples) in this manner, the prior art does not include a surgical instrument for firing a coil fastener within a tube-like organ, such as a colon or intestine, for example. Unlike the firing of surgical staples from a surgical stapler, for example, firing a coil fastener from a coil fastener applier generally requires rotational movement of the coil fastener. A coil fastener applier usable both intralumenally and non-intralumenally is desired.